Obesity has become epidemic in U.S. children and adolescents. An unfortunate consequence of this epidemic is the recent recognition of the metabolic syndrome in adolescents, a condition that was historically an adult entity. The main purpose of the proposed R-21 study is to use Community Based Participatory Research (CBPR) methodology to create, implement and evaluate a culturally relevant and age-appropriate obesity intervention (ACTION) for primarily Hispanic adolescents who are overweight. The intervention will be implemented through Albuquerque Public Schools'School-Based Health Centers (SBHCs). ACTION has 3 primary components that were jointly determined with SBHC providers and students in preparing the current proposal: biweekly clinical encounters with SBHC providers, use of Motivational Enhancement Therapy to help overweight adolescents adopt healthier behaviors (specifically increase fruits and vegetable, decrease high fat foods, decrease high sugar beverages, increase physical activity and decrease sedentary behavior), and use of a community advisory council to develop strategies specific to the Stages of Change which will be delivered by print and DVD media. Additional formative research with teens, parents, and school staff will be conducted to explore the potential social, institutional and policy level mechanisms that can be added to ACTION to support high school students in achieving a healthier lifestyle. Intervention components will be modified as suggested by the community advisory council. To test efficacy of the ACTION intervention in one semester, overweight adolescents who are ready to change will be recruited. The study will employ a quasi-experimental design in which one SBHC will deliver the intervention condition and another SBHC will deliver the control condition. Students will have pre- and post- intervention measurements at both SBHC sites to assess if adolescents in the intervention condition will have improved risk factor profile for metabolic syndrome, improved nutrition and improved physical activity when compared with students in the control condition. Analytical approaches will include both cross-sectional analyses at each point in time, pre-post comparisons within each group and comparison of change between the intervention and control groups. This study will provide formative data on potential social, institutional and policy level mechanisms to support high school students in achieving a healthier lifestyle and pilot data on the efficacy of the developed intervention which will be used to plan and design a full-scale intervention for an R34/R01 submission. PUBLIC HEALTH RELEVANCE: Recent estimate of overweight and obese adolescents, ages 12-19 years, in the U.S. is 11%. Healthy People 2010 has set an objective to reduce the proportion of adolescents who are overweight or obese to 5%. The proposed study, ACTION, will contribute greatly to addressing this critical public health problem of childhood obesity through the innovative mechanism of using School-Based Health Centers.